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The Elephant in the Room of Grief
By Beth Christopherson, LCSW

Many theoretical models have been proposed to better understand grief. Constructivist theories, attachment theories, and task theories have all been used to explain the pathways and clinical implications of the grief process (Neimeyer, Harris, Winokuer, & Thornton, 2011). These models are beneficial for researchers who scientifically examine the nature of grief, as well as for social workers and other mental health providers to develop more comprehensive and nuanced treatment approaches.

The Pew Forum on Religion and Public Life reports that 74% of Americans believe in life after death. As the majority of Americans believe or hope that an afterlife is possible, why are clinicians and scholars not addressing the topic of the afterlife more directly, by providing resources on the afterlife that could provide additional healing benefits? It is important that this elephant in the room—the belief, hope in, or desire to explore the possibility of an afterlife—be more directly assessed and addressed.

Clinicians, care providers, and support groups can appropriately and ethically integrate these resources and options into a client's religious and spiritual belief system. These resources can lead to more comprehensive healing, such as through the following:
• the normalization of the belief in and questions about the afterlife as well as spiritual experiences such as after-death communications (ADCs);
• the reassurance, support, and data for the griever to indicate that an afterlife is real or at least possible; and
• the comfort provided when a griever believes that the departed is at peace, continues to be a part of their life, and that they will see each other again someday.

Why Do Grief Research and Practice Neglect the Afterlife?

Academic scholars conduct and rely on empirical research to draw relevant conclusions. Gathering data on the possibility of the existence of an afterlife is challenging at best. Furthermore, survival of consciousness is a taboo scientific topic, one that many researchers avoid (Radin, 2013). However, some quantitative studies and other research publications show some support for the survival of consciousness hypothesis (Beischel, Boccuzzi, Biuso, & Rock, 2015; Greyson, 2010; Kelly & Arcangel, 2011; Beischel, Mosher, & Boccuzzi, 2014-2015).

Clinicians are also hesitant to approach the topic of the afterlife, because they must be careful not to impose a religious or spiritual belief system on the client, leaving this to the client's own religious or spiritual leaders, such as a pastor or rabbi. However, many clients may believe in an afterlife but do not strongly identify with a particular religion, as most Americans do not have a dogmatic approach to their faith, according to the previously mentioned Pew study. The afterlife is as much of a philosophical and scientific topic as it is a spiritual one.

Some research indicates a widespread lack of quality in the implementation of biopsychosocial-spiritual assessments by clinicians, and only a minority of clinicians may actually be providing religious or spiritual resources even when it could be beneficial for the client (Oxhandler, Parrish, Torres, & Achenbaum, 2015). By extension, it is reasonable to surmise that most clinicians are not assessing grieving clients about their belief in an afterlife, let alone integrating that aspect of their clients' belief system into treatment.

Afterlife Resources/Healing Options With Hope for an Afterlife

A thorough biopsychosocial-spiritual assessment is needed to determine the broader context for the appropriateness and timing of any afterlife resources provided to a client—if any resources are provided at all. Certainly, clients exhibiting suicidal ideation, self-harm behaviors, extreme anger or anxiety, or psychosis do not require afterlife resources; they require immediate forms of stabilization, such as through emergency or inpatient care, medication evaluation, and traditional therapeutic modalities. Also, for the first several months, afterlife resources may distract from the more pressing needs of many clients. For example, a husband whose wife died a month ago may benefit more from planning out the newfound childcare responsibilities and identifying a social support network.

Mediumship

Mediums who have a defined code of ethics and practice evidential mediumship, defined as mediumship that provides specific accurate and relevant information about the departed to the client, can be a valuable option of healing for those with grief. Mediumship is a resource that some clients already seek on their own, and it is one to which therapists could refer clients as a nonpsychotherapeutic, spiritual resource. Clients receiving evidential mediumship can result in less fear of death, more peace or closure with unresolved issues with the departed, and a sense of comfort in the belief that the departed continue to support the living.

Bestselling author and grief therapist, Claire Bidwell Smith, writes in her book After This: When Life Is Over, Where Do We Go?, "Before exploring these psychic medium sessions, I would never have considered recommending that one of my clients visit a medium … I assumed that all mediums were likely quacks, and that seeing a medium when you are grieving is a sure sign of denial and desperation. But all that has changed now" (p. 123). Smith shares her personal experiences and some of the experiences of those close to her who had healing benefits from medium readings. Complementing this, it is important that the clinician identify and review both the potential benefits and risks, then provide therapeutic support to the client before, during, and after the reading. Working with the clinician, clients may want to strengthen, change, or continue to process the relationship they have with the departed after a reading with a medium.

The Windbridge Institute is currently raising money to conduct the Bereavement and Mediumship study, a randomized, clinical study on mediumship and its effects on grief. This and future similar studies will inform who most benefits from a medium reading, the potential risks of a medium reading, as well as how the clinician can best assist the client in integrating the messages of the reading into his/her life.

Afterlife Discussion Groups

Afterlife discussion groups are especially valuable for clients who feel that they may be shamed for discussing their belief in or questions about the afterlife with their friends or family. To be clear, these groups are not psychotherapy groups; they are a complementary, nonpsychotherapeutic spiritual and/or educational resource. Furthermore, afterlife discussion groups can be very beneficial for those who have had spiritual experiences such as ADCs, which are defined as subjective experiences of sensing the presence of the deceased. Those who have experienced an ADC could benefit from being able to connect with others who can relate to the experience and/or validate that the experience was "real." In research literature, most ADCs are reported as positive, and they are quite common (LaGrand, 2005; Nowatzki & Kalischuk, 2009). The Forever Family Foundation is an example of an organization that provides these groups, both in-person and online.

Afterlife Research Resources

Research and support communities on topics including the afterlife, consciousness, and spiritual experiences may be beneficial for some clients with grief. The Windbridge Institute conducts afterlife and mediumship research. Many of their studies are available online, and some clients may want to read their research on mediumship. The University of Virginia, Division of Perceptual Studies, conducts research on near-death experiences, deathbed visions, and reincarnation. These studies provide support that consciousness (called a soul by many speaking from a spiritual perspective) can go beyond the brain. The International Association of Near-Death Studies is a good resource for near-death experiencers or for those who are interested in learning more about what those who have died recall. The After-Death Communication Research Foundation compiles ADC accounts and provides a supportive online community for ADC experiencers. The clinician must inform the client beforehand that a variety of conclusions, some of which may not be in the client's belief system, will be expressed by the researchers, group members, and publications of these organizations and that afterlife and consciousness research continues to burgeon. The above resources provide data to support that an afterlife is possible, thus bringing hope and reassurance to some of those experiencing grief.

Induced After-Death Communication

Induced after-death communication (IADC) is a healing method for treating grief that is conducted by trained clinicians. The IADC method utilizes eye movements or other kinds of bilateral stimulation and is reported to result in a high frequency of the client experiencing a positive, subjective sense of presence of the deceased (Botkin, 2000; http://www.induced-adc.com/). While using IADC at the VA, Botkin (2000) saw significant healing of grief and trauma symptoms. "Of the 83 patients who participated in an ADC induction, 81 (98%) achieved an ADC ... Of the 81 patients who achieved an ADC, 78 (96%) reported full resolution of grief following the ADC [and] 76 (94%) believed their ADC was an actual spiritual contact" (p. 198).

Clients who experience an ADC can potentially replace disturbing memories with the positive sense of presence of the departed, bringing peace to the client. Importantly, one does not have to believe in an afterlife in order to experience an ADC. In fact, such clients treated with IADC are just as likely to experience the induced ADC. Therapists trained in IADC can speak further about risks and benefits of the experience, and these therapists can be found at www.induced-adc.com/trained-therapists-directory. In addition, compelling testimonies of healing from IADC by veterans of the military can be found in "After the War" videos at www.healingafterthewar.org/videos.html.

Discussing the Departed in Psychotherapy Sessions

In psychotherapy sessions, the clinician can explicitly ask the client if and how he or she would like to continue a relationship with the departed. There is ample literature in the academic field of bereavement on the phenomena of continuing bonds with the departed (Klass, Silverman, & Nickman, 1996). Generally, most continuing bonds appear to be associated with adaptive grieving; however, clinicians must perform a thorough assessment, as some continuing bonds may indicate poor adjustment (Field & Filanosky, 2009; Stroebe, Abakoumkin, Stroebe, & Schut, 2012). When clinically appropriate, the clinician can assist the client in continuing a relationship with the departed in ways that fully engage with the living and optimize the client's quality of life. Some clients may not want to continue any kind of relationship with the departed, and the clinician should respect this decision. Others may want to continue the relationship in a way that solely connects to the memory or legacy of the departed. Because most Americans believe in an afterlife, however, many clients seeking grief therapy will have an interest in an ongoing relationship with the departed—one that assumes the departed is still engaged in the lives of the living—but many clients may feel shameful, silly, or "crazy" for expressing this. Therefore, it is important that the clinician directly assess this aspect of the client's belief system and not assume the client will bring it up independently.

Final Thoughts

Theoretically based models of the grief process, and their accompanying guidelines for clinical practice, are highly valuable for understanding the complex factors of grief and related psychotherapeutic treatment options. However, when mental health providers are not assessing the belief or hope in an afterlife, and providing additional options that incorporate this belief, an opportunity for more comprehensive healing benefits is lost. The widespread belief in the afterlife, as reflected in national survey data and in the popularity of shows on mediumship and ghosts, demonstrates the core need of many to explore the afterlife as part of their belief and coping system. Moving forward, a collaborative effort between grief scholars, afterlife researchers, and clinicians would beneficially inform best practices for integrating afterlife resources into grief treatment. The elephant in the room of grief should be directly addressed, as it leads to more healing options and addresses the core of the suffering of grief for so many. Grief is often described as a pit, but it does not necessarily have to be bottomless.